柏中胜,肖栋,彭朝梅,曹龙兴,张小敏,肖国胜

• 1:厦门大学附属心血管病医院心内科

摘要(Abstract)：

目的 探讨非急性心肌梗死患者经皮冠状动脉介入治疗（PCI）术后定量血流分数（QFR）对术后3年主要不良心血管事件（MACE）发生的预测价值。方法 本研究纳入厦门大学附属心血管病医院心脏导管室2020年1-6月行PCI的139例非急性心肌梗死患者，术后均测量靶血管QFR值，并随访患者术后3年MACE发生情况。通过受试者工作特征（ROC）曲线计算出QFR截断值，根据截断值将患者分成QFR>0.95组和QFR≤0.95组，根据是否发生MACE分成MACE组和非MACE组。通过单因素及多因素线性回归分析探讨非急性心肌梗死患者PCI术后QFR的独立影响因素，采用单因素及多因素Cox回归分析探讨PCI术后QFR对非急性心肌梗死患者术后3年MACE发生的预测价值。通过绘制无MACE生存曲线对比QFR>0.95组和QFR≤0.95组患者远期预后。结果 通过ROC曲线分析得出PCI术后QFR预测非急性心肌梗死患者术后3年MACE发生有统计学意义（AUC 0.666,95%CI 0.556～0.777,P=0.003），且预测MACE发生的截断值为0.95，根据截断值将患者分为QFR≤0.95组（74例）和QFR>0.95组（65例）。多因素线性回归分析显示，PCI术后最大支架面积狭窄率是术后QFR的独立影响因素（P<0.001）。多因素Cox回归分析显示身体质量指数（BMI）、术后QFR、三支血管病变、术后QFR分组是无MACE生存期的独立影响因素。无MACE生存曲线显示：QFR>0.95组患者远期预后明显优于QFR≤0.95组（χ~2=5.272,P=0.022）。结论 PCI术后QFR预测非急性心肌梗死患者术后3年MACE发生的最佳截断值为0.95，且术后QFR≤0.95的患者远期预后较差。BMI、三支血管病变、术后QFR≤0.95是非急性心肌梗死患者PCI术后3年MACE发生的独立危险因素。

关键词(KeyWords)： 经皮冠状动脉介入治疗;定量血流分数;非急性心肌梗死;主要不良心血管事件

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 柏中胜,肖栋,彭朝梅,曹龙兴,张小敏,肖国胜

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